PBTB | Senior Manager, Claims

Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed. Job Purpose: Oversee end-to-end claims management across multiple portfolios, ensuring timely, fair and compliant claims decisions while optimising cost efficiency and customer experience. Key Accountabilities: Oversee inpatient/outpatient medical reimbursement, personal accident and allowance claims to ensure accurate and timely assessment based on certificate terms                                             Manage high-value and complex claims (death, TPD, critical illness), ensuring consistent decisions aligned with underwriting intent, legal and Shariah requirements                                                    Oversee group and corporate claims including TPA management to ensure SLA fulfillment and effective performance monitoring                                                   Supervise cashless and non-cashless claims payments, ensuring efficient settlement, provider query resolution and payment accuracy                                                      Manage claim suspense accounts, unclaimed monies, and ensure strong financial controls and reconciliation accuracy                                                     Collaborate with cross-functional stakeholders and external partners to resolve complex claims cases                                                       Lead process improvement and system enhancement initiatives to optimise claims efficiency and digitalisation                                                          Lead, develop and mentor team leads and specialists, fostering a high-performance and customer-centric culture              Key Requirements: Bachelor’s degree in insurance, Business Administration, Medical Science, Actuarial Science, or a related field.                                                                                            Professional insurance certifications such as Fellow Life Management Institute (FLMI), Associate Insurance Institute (AII), or equivalent industry qualifications. Training in leadership, operational excellence, or process improvement methodologies (e.g Lean Six Sigma, project management) will be an added advantage.                                                                                                                                                       Minimum 10 years of experience in insurance/takaful claims management, preferably covering life, health, and group business portfolios with 3 years in a senior leadership or managerial role, overseeing multiple functional teams.                     Proven track record in managing diverse claims portfolios (medical reimbursement, accidental, death, TPD, critical illness, cashless/non-cashless payments, group/affinity claims; handling sensitive high value and complex claims with sound judgement; managing TPA performance, audit and SLAs; d) driving process improvement, digital transformation, and